|
HC CATH PIGTAIL 5.5F 70CM
|
Facility
|
IP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
|
|
HC CATH PIGTAIL 5.5F 70CM
|
Facility
|
OP
|
$112.94
|
|
| Hospital Charge Code |
901602726
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.72
|
| Rate for Payer: Blue Distinction Transplant |
$67.76
|
| Rate for Payer: Blue Shield of California Commercial |
$71.04
|
| Rate for Payer: Blue Shield of California EPN |
$55.23
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Central Health Plan Commercial |
$90.35
|
| Rate for Payer: Cigna of CA HMO |
$72.28
|
| Rate for Payer: Cigna of CA PPO |
$83.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.00
|
| Rate for Payer: Dignity Health Media |
$96.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.65
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$84.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.59
|
| Rate for Payer: Multiplan Commercial |
$84.70
|
| Rate for Payer: Networks By Design Commercial |
$73.41
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: Riverside University Health System MISP |
$45.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.47
|
| Rate for Payer: United Healthcare All Other HMO |
$56.47
|
| Rate for Payer: United Healthcare HMO Rider |
$56.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.00
|
| Rate for Payer: Vantage Medical Group Senior |
$96.00
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
OP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$102.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.40
|
| Rate for Payer: Blue Distinction Transplant |
$68.45
|
| Rate for Payer: Blue Shield of California Commercial |
$71.76
|
| Rate for Payer: Blue Shield of California EPN |
$55.79
|
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: Cigna of CA HMO |
$73.01
|
| Rate for Payer: Cigna of CA PPO |
$84.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.97
|
| Rate for Payer: Dignity Health Media |
$96.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$85.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
| Rate for Payer: Riverside University Health System MISP |
$45.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.04
|
| Rate for Payer: United Healthcare All Other HMO |
$57.04
|
| Rate for Payer: United Healthcare HMO Rider |
$57.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.97
|
| Rate for Payer: Vantage Medical Group Senior |
$96.97
|
|
|
HC CATH PIGTAIL 5FR 90CM
|
Facility
|
IP
|
$114.08
|
|
| Hospital Charge Code |
901602725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$102.67 |
| Rate for Payer: Cash Price |
$51.34
|
| Rate for Payer: Central Health Plan Commercial |
$91.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.63
|
| Rate for Payer: Galaxy Health WC |
$96.97
|
| Rate for Payer: Global Benefits Group Commercial |
$68.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$102.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$85.56
|
| Rate for Payer: Networks By Design Commercial |
$74.15
|
| Rate for Payer: Prime Health Services Commercial |
$96.97
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.01
|
| Rate for Payer: United Healthcare All Other HMO |
$213.90
|
| Rate for Payer: United Healthcare HMO Rider |
$209.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$191.40
|
|
|
HC CATH PLEURAL FUHRMAN 8.5FR BK
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602839
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$323.06
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH PMO LICOX
|
Facility
|
IP
|
$12.30
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Cash Price |
$5.54
|
| Rate for Payer: Central Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.92
|
| Rate for Payer: Galaxy Health WC |
$10.46
|
| Rate for Payer: Global Benefits Group Commercial |
$7.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.46
|
| Rate for Payer: Multiplan Commercial |
$9.22
|
| Rate for Payer: Networks By Design Commercial |
$8.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.46
|
|
|
HC CATH PMO LICOX
|
Facility
|
OP
|
$12.30
|
|
| Hospital Charge Code |
901695700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.27
|
| Rate for Payer: Blue Distinction Transplant |
$7.38
|
| Rate for Payer: Blue Shield of California Commercial |
$7.74
|
| Rate for Payer: Blue Shield of California EPN |
$6.01
|
| Rate for Payer: Cash Price |
$5.54
|
| Rate for Payer: Central Health Plan Commercial |
$9.84
|
| Rate for Payer: Cigna of CA HMO |
$7.87
|
| Rate for Payer: Cigna of CA PPO |
$9.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.46
|
| Rate for Payer: Dignity Health Media |
$10.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.92
|
| Rate for Payer: Galaxy Health WC |
$10.46
|
| Rate for Payer: Global Benefits Group Commercial |
$7.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.07
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.46
|
| Rate for Payer: Multiplan Commercial |
$9.22
|
| Rate for Payer: Networks By Design Commercial |
$8.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.46
|
| Rate for Payer: Riverside University Health System MISP |
$4.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.15
|
| Rate for Payer: United Healthcare All Other HMO |
$6.15
|
| Rate for Payer: United Healthcare HMO Rider |
$6.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.46
|
| Rate for Payer: Vantage Medical Group Senior |
$10.46
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
IP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
|
|
HC CATH POV EXTND DWELL 2FR 22GA
|
Facility
|
OP
|
$238.00
|
|
| Hospital Charge Code |
901698219
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$144.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.61
|
| Rate for Payer: Blue Distinction Transplant |
$142.80
|
| Rate for Payer: Blue Shield of California Commercial |
$149.70
|
| Rate for Payer: Blue Shield of California EPN |
$116.38
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Central Health Plan Commercial |
$190.40
|
| Rate for Payer: Cigna of CA HMO |
$152.32
|
| Rate for Payer: Cigna of CA PPO |
$176.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.30
|
| Rate for Payer: Dignity Health Media |
$202.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$202.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$214.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$178.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$83.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$178.50
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
| Rate for Payer: Riverside University Health System MISP |
$95.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.00
|
| Rate for Payer: United Healthcare All Other HMO |
$119.00
|
| Rate for Payer: United Healthcare HMO Rider |
$119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$119.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$202.30
|
| Rate for Payer: Vantage Medical Group Senior |
$202.30
|
|
|
HC CATH POWERLINE TUNNELED
|
Facility
|
OP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$809.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$672.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$819.90
|
| Rate for Payer: Blue Distinction Transplant |
$883.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,104.00
|
| Rate for Payer: Blue Shield of California EPN |
$800.77
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,251.20
|
| Rate for Payer: Dignity Health Media |
$1,251.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,104.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$515.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$736.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: Riverside University Health System MISP |
$588.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$883.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$883.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$736.00
|
| Rate for Payer: United Healthcare All Other HMO |
$736.00
|
| Rate for Payer: United Healthcare HMO Rider |
$736.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$736.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,251.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,251.20
|
|
|
HC CATH POWERLINE TUNNELED
|
Facility
|
IP
|
$1,472.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909000028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.40 |
| Max. Negotiated Rate |
$1,324.80 |
| Rate for Payer: Blue Shield of California EPN |
$786.05
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,177.60
|
| Rate for Payer: Cigna of CA HMO |
$1,030.40
|
| Rate for Payer: Cigna of CA PPO |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$588.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$588.80
|
| Rate for Payer: Galaxy Health WC |
$1,251.20
|
| Rate for Payer: Global Benefits Group Commercial |
$883.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,324.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$560.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$294.40
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$555.83
|
| Rate for Payer: United Healthcare All Other HMO |
$542.87
|
| Rate for Payer: United Healthcare HMO Rider |
$531.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$485.76
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
IP
|
$1,152.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.58 |
| Max. Negotiated Rate |
$1,037.61 |
| Rate for Payer: Blue Shield of California EPN |
$615.65
|
| Rate for Payer: Cash Price |
$518.81
|
| Rate for Payer: Central Health Plan Commercial |
$922.32
|
| Rate for Payer: Cigna of CA HMO |
$807.03
|
| Rate for Payer: Cigna of CA PPO |
$807.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$461.16
|
| Rate for Payer: Galaxy Health WC |
$979.96
|
| Rate for Payer: Global Benefits Group Commercial |
$691.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$768.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.58
|
| Rate for Payer: Multiplan Commercial |
$864.68
|
| Rate for Payer: Prime Health Services Commercial |
$979.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$435.34
|
| Rate for Payer: United Healthcare All Other HMO |
$425.19
|
| Rate for Payer: United Healthcare HMO Rider |
$415.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$380.46
|
|
|
HC CATH POWER PICC 4FR SL
|
Facility
|
OP
|
$1,152.90
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606421
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.58 |
| Max. Negotiated Rate |
$1,037.61 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$979.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$634.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$634.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$526.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$642.17
|
| Rate for Payer: Blue Distinction Transplant |
$691.74
|
| Rate for Payer: Blue Shield of California Commercial |
$864.68
|
| Rate for Payer: Blue Shield of California EPN |
$627.18
|
| Rate for Payer: Cash Price |
$518.81
|
| Rate for Payer: Central Health Plan Commercial |
$922.32
|
| Rate for Payer: Cigna of CA HMO |
$807.03
|
| Rate for Payer: Cigna of CA PPO |
$807.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$979.96
|
| Rate for Payer: Dignity Health Media |
$979.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$979.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$461.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$461.16
|
| Rate for Payer: Galaxy Health WC |
$979.96
|
| Rate for Payer: Global Benefits Group Commercial |
$691.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,037.61
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$864.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$403.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$768.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$439.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.58
|
| Rate for Payer: Multiplan Commercial |
$864.68
|
| Rate for Payer: Networks By Design Commercial |
$576.45
|
| Rate for Payer: Prime Health Services Commercial |
$979.96
|
| Rate for Payer: Riverside University Health System MISP |
$461.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$691.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$691.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$576.45
|
| Rate for Payer: United Healthcare All Other HMO |
$576.45
|
| Rate for Payer: United Healthcare HMO Rider |
$576.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$576.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$979.96
|
| Rate for Payer: Vantage Medical Group Senior |
$979.96
|
|
|
HC CATH POWER PICC TLS 4FR SL
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$442.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$367.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$448.38
|
| Rate for Payer: Blue Distinction Transplant |
$483.00
|
| Rate for Payer: Blue Shield of California Commercial |
$603.75
|
| Rate for Payer: Blue Shield of California EPN |
$437.92
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Media |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$603.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$281.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$402.50
|
| Rate for Payer: United Healthcare All Other HMO |
$402.50
|
| Rate for Payer: United Healthcare HMO Rider |
$402.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$402.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC CATH POWER PICC TLS 4FR SL
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901695316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Blue Shield of California EPN |
$429.87
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.97
|
| Rate for Payer: United Healthcare All Other HMO |
$296.88
|
| Rate for Payer: United Healthcare HMO Rider |
$290.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$265.65
|
|
|
HC CATH, PREMICATH 1FR 28G,20CM
|
Facility
|
IP
|
$339.99
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$305.99 |
| Rate for Payer: Blue Shield of California EPN |
$181.55
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Central Health Plan Commercial |
$271.99
|
| Rate for Payer: Cigna of CA HMO |
$237.99
|
| Rate for Payer: Cigna of CA PPO |
$237.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$136.00
|
| Rate for Payer: Galaxy Health WC |
$288.99
|
| Rate for Payer: Global Benefits Group Commercial |
$203.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$305.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.00
|
| Rate for Payer: Multiplan Commercial |
$254.99
|
| Rate for Payer: Prime Health Services Commercial |
$288.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$128.38
|
| Rate for Payer: United Healthcare All Other HMO |
$125.39
|
| Rate for Payer: United Healthcare HMO Rider |
$122.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$112.20
|
|
|
HC CATH, PREMICATH 1FR 28G,20CM
|
Facility
|
OP
|
$339.99
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698429
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$305.99 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$155.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$189.37
|
| Rate for Payer: Blue Distinction Transplant |
$203.99
|
| Rate for Payer: Blue Shield of California Commercial |
$254.99
|
| Rate for Payer: Blue Shield of California EPN |
$184.95
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Central Health Plan Commercial |
$271.99
|
| Rate for Payer: Cigna of CA HMO |
$237.99
|
| Rate for Payer: Cigna of CA PPO |
$237.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.99
|
| Rate for Payer: Dignity Health Media |
$288.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$136.00
|
| Rate for Payer: Galaxy Health WC |
$288.99
|
| Rate for Payer: Global Benefits Group Commercial |
$203.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$305.99
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$254.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$119.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.00
|
| Rate for Payer: Multiplan Commercial |
$254.99
|
| Rate for Payer: Networks By Design Commercial |
$170.00
|
| Rate for Payer: Prime Health Services Commercial |
$288.99
|
| Rate for Payer: Riverside University Health System MISP |
$136.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$170.00
|
| Rate for Payer: United Healthcare All Other HMO |
$170.00
|
| Rate for Payer: United Healthcare HMO Rider |
$170.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$170.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.99
|
| Rate for Payer: Vantage Medical Group Senior |
$288.99
|
|
|
HC CATH PRIMO MALE 16" 12FR COUDE
|
Facility
|
IP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$19.93 |
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.60
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 12FR COUDE
|
Facility
|
OP
|
$22.14
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.08
|
| Rate for Payer: Blue Distinction Transplant |
$13.28
|
| Rate for Payer: Blue Shield of California Commercial |
$13.93
|
| Rate for Payer: Blue Shield of California EPN |
$10.83
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Cash Price |
$9.96
|
| Rate for Payer: Central Health Plan Commercial |
$17.71
|
| Rate for Payer: Cigna of CA HMO |
$14.17
|
| Rate for Payer: Cigna of CA PPO |
$16.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.82
|
| Rate for Payer: Dignity Health Media |
$18.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.86
|
| Rate for Payer: Galaxy Health WC |
$18.82
|
| Rate for Payer: Global Benefits Group Commercial |
$13.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.93
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.43
|
| Rate for Payer: Multiplan Commercial |
$16.60
|
| Rate for Payer: Networks By Design Commercial |
$14.39
|
| Rate for Payer: Prime Health Services Commercial |
$18.82
|
| Rate for Payer: Riverside University Health System MISP |
$8.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.07
|
| Rate for Payer: United Healthcare All Other HMO |
$11.07
|
| Rate for Payer: United Healthcare HMO Rider |
$11.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.82
|
| Rate for Payer: Vantage Medical Group Senior |
$18.82
|
|
|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
IP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Cash Price |
$10.67
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
|
|
HC CATH PRIMO MALE 16" 14FR COUDE
|
Facility
|
OP
|
$23.70
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607696
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$343.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$343.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.00
|
| Rate for Payer: Blue Distinction Transplant |
$14.22
|
| Rate for Payer: Blue Shield of California Commercial |
$14.91
|
| Rate for Payer: Blue Shield of California EPN |
$11.59
|
| Rate for Payer: Cash Price |
$10.67
|
| Rate for Payer: Cash Price |
$10.67
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: Cigna of CA HMO |
$15.17
|
| Rate for Payer: Cigna of CA PPO |
$17.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.14
|
| Rate for Payer: Dignity Health Media |
$20.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
| Rate for Payer: Riverside University Health System MISP |
$9.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.85
|
| Rate for Payer: United Healthcare All Other HMO |
$11.85
|
| Rate for Payer: United Healthcare HMO Rider |
$11.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.14
|
| Rate for Payer: Vantage Medical Group Senior |
$20.14
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
OP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,894.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,309.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,990.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,990.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,633.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,212.77
|
| Rate for Payer: Blue Distinction Transplant |
$3,262.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,420.50
|
| Rate for Payer: Blue Shield of California EPN |
$2,659.18
|
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,350.40
|
| Rate for Payer: Cigna of CA HMO |
$3,480.32
|
| Rate for Payer: Cigna of CA PPO |
$4,024.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,622.30
|
| Rate for Payer: Dignity Health Media |
$4,622.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,622.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,894.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,078.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,903.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,627.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,071.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,087.60
|
| Rate for Payer: Multiplan Commercial |
$4,078.50
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,175.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,262.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,262.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,719.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,719.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,719.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,719.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,622.30
|
| Rate for Payer: Vantage Medical Group Senior |
$4,622.30
|
|
|
HC CATH PRYTIME ER REBOA
|
Facility
|
IP
|
$5,438.00
|
|
|
Service Code
|
CPT C2628
|
| Hospital Charge Code |
900502628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,087.60 |
| Max. Negotiated Rate |
$4,894.20 |
| Rate for Payer: Cash Price |
$2,447.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,350.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,175.20
|
| Rate for Payer: Galaxy Health WC |
$4,622.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,262.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,627.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,071.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,087.60
|
| Rate for Payer: Multiplan Commercial |
$4,078.50
|
| Rate for Payer: Networks By Design Commercial |
$3,534.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,622.30
|
|
|
HC CATH PUREWICK EXTERNAL FEMALE
|
Facility
|
OP
|
$74.54
|
|
| Hospital Charge Code |
901698540
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$67.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.04
|
| Rate for Payer: Blue Distinction Transplant |
$44.72
|
| Rate for Payer: Blue Shield of California Commercial |
$46.89
|
| Rate for Payer: Blue Shield of California EPN |
$36.45
|
| Rate for Payer: Cash Price |
$33.54
|
| Rate for Payer: Central Health Plan Commercial |
$59.63
|
| Rate for Payer: Cigna of CA HMO |
$47.71
|
| Rate for Payer: Cigna of CA PPO |
$55.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.36
|
| Rate for Payer: Dignity Health Media |
$63.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$63.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.82
|
| Rate for Payer: Galaxy Health WC |
$63.36
|
| Rate for Payer: Global Benefits Group Commercial |
$44.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$67.09
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$55.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.91
|
| Rate for Payer: Multiplan Commercial |
$55.90
|
| Rate for Payer: Networks By Design Commercial |
$48.45
|
| Rate for Payer: Prime Health Services Commercial |
$63.36
|
| Rate for Payer: Riverside University Health System MISP |
$29.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$37.27
|
| Rate for Payer: United Healthcare All Other HMO |
$37.27
|
| Rate for Payer: United Healthcare HMO Rider |
$37.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$63.36
|
| Rate for Payer: Vantage Medical Group Senior |
$63.36
|
|
